Healthcare Provider Details

I. General information

NPI: 1255109096
Provider Name (Legal Business Name): RONNELL HINSON RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOSPITAL DR
COLUMBIA MO
65201-5275
US

IV. Provider business mailing address

4109 TREETOP LN
COLUMBIA MO
65202-6218
US

V. Phone/Fax

Practice location:
  • Phone: 573-814-6000
  • Fax: 573-814-6674
Mailing address:
  • Phone: 573-489-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number2005006904
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: